Individual
GREGORY D KINGSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
125 S 20TH ST, PADUCAH, KY 42001-7100
(270) 575-3247
(270) 442-7335
Mailing address
117 S 2ND ST, PO BOX 497, AUGUSTA, AR 72006-2309
(870) 347-2534
(870) 347-3492
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3002602
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6592143900
—
KY
05
—
78260205
—
KY
05
—
78900180
—
KY
01
—
P01026376
RAILROAD MEDICARE LPS
KY
Enumeration date
01/29/2007
Last updated
01/03/2020
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